How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $7,943.28 Median $8,709.64 Typical High $8,912.51 | Professional | None | $7,943.28 | $8,709.64 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
HMSA Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $676.08 | Professional | None | $5.01 | $5.01 | $676.08 |
United Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,709.64 | Professional | None | $8,317.64 | $8,317.64 | $8,709.64 |
University Health Alliance Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3,981.07 Median $4,365.16 Typical High $4,466.84 | Professional | 52 · Reduced service | $3,981.07 | $4,365.16 | $4,466.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,584.89 Median $1,737.80 Typical High $1,778.28 | Professional | 53 · Discontinued | $1,584.89 | $1,737.80 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,202.26 Median $1,318.26 Typical High $1,348.96 | Professional | 55 · Aftercare only | $1,202.26 | $1,318.26 | $1,348.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $794.33 Median $870.96 Typical High $891.25 | Professional | 56 · Pre-op care only | $794.33 | $870.96 | $891.25 |
Where Hawaii sits
The same service costs 26.3 times more in Alaska than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Hawaii· 49th of 51
$8,318
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.